Paragonimus (eating raw or undercooked Crab, Crayfish and Other Mammals)

Complications /Information to beware of/General tips:

Do not wait, phone for an ambulance if have or develop:

• Encephalitis (parasite has travelled to the brain)
• Meningitis (parasite has travelled to the brain)
• Ciguatera fish poisoning

This condition can cause:

• Bronchitis
• Coughing up blood
• Weight loss
• Vitamin B12 deficiency (Pernicious anaemia)

Temperature for cooking crab or crayfish

• The FDA advises cooking crab or crayfish to 145 F (or 63 C). That means that the internal temperature of the crab/crayfish should reach 145 F (63 C).
• The meat should be opaque and pearly.

FDA

• Always the above meats thoroughly and one should avoid eating them raw including from frozen (Paragonimus parasites are are more resistant to freezing than other parasites).
• Travelers should be advised to avoid traditional meals containing undercooked freshwater crustaceans.

Travel

If you’re travelling to a country where there’s a high risk of getting the condition, the Information below can help prevent infection:

• Don’t drink the local water unless you’re sure it’s clean (sterile) – drink bottled water or drinks in sealed cans or bottles.
• If the water isn’t sterile, boil it for several minutes or use chemical disinfectant or a reliable filter.
• Don’t clean your teeth with tap water.
• Don’t have ice in your drinks because it may be made from unclean water.
• Avoid fresh fruit or vegetables that can’t be peeled before eating.
• Avoid food and drink sold by street vendors, except drinks in properly sealed cans or bottles.

NHS choices

Future advise especially when travelling to an infectious country:

• Always wash your hands
• Fresh foods: those that are peeled or cooked are the safest
• Avoid high risk foods like shellfish
• Boiling water is the best method of sterilisation
• Chemicals are useful for preparing safe drinking water but have their limitations
• Chlorine-based tablets are widely available and will be appropriate for most travellers
• More intrepid travellers and those planning to use surface waters as a drinking water source should use an iodine-based product.

• Iodine or chlorine used for water purification (as discussed later) can also be used for soaking and manufacturers of food products give recommendations for the appropriate concentrations.

There are three methods by which the traveller can prepare clean drinking water:

• Boiling:
  • Boil water for a full five minutes at any altitude.
• Chemical disinfection:
  • Iodine, chlorine, katedyne silver.
• Filtration

The Pharmaceutical Journal, PJ, January 2000;():DOI:10.1211/PJ.2000.20000218

This condition may show similar symptoms to:

• Anisakis
• Bacterial Gastroenteritis
• Tuberculosis
• Viral Gastroenteritis
• Vibrio Vulnificus

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice